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[Mood disorders: When should we use repetitive transcranial magnetic stimulation?] 2019
Samuel Bulteau, and
Charline Guirette, and
Jérôme Brunelin, and
Emmanuel Poulet, and
Benoît Trojak, and
Raphaëlle Richieri, and
David Szekely, and
Djamila Bennabi, and
Antoine Yrondi, and
Maud Rotharmel, and
Thierry Bougerol, and
Gaëlle Dall'Igna, and
Jérôme Attal, and
René Benadhira, and
Noomane Bouaziz, and
Maxime Bubrovszky, and
Benjamin Calvet, and
Sonia Dollfus, and
Jack Foucher, and
Filipe Galvao, and
Aurélia Gay, and
Frédéric Haesebaert, and
Emmanuel Haffen, and
Isabelle Jalenques, and
Dominique Januel, and
Renaud Jardri, and
Bruno Millet, and
Clément Nathou, and
Cecilia Nauczyciel, and
Marion Plaze, and
Fady Rachid, and
Jean-Marie Vanelle, and
Anne Sauvaget
CHU de Nantes, addictology and liaison psychiatry department, 44000 Nantes, France; University of Nantes, university of Tours, Inserm, SPHERE U1246, 44000 Nantes, France.
Repeated transcranial magnetic stimulation (rTMS) is still a recent treatment in psychiatry. This article aims at updating the clinicians'knowledge about rTMS in the treatment of mood disorders (uni and bipolar depressive disorders, manic/mixed states, suicidal risk, catatonia). It is intended for clinicians who are required to indicate and/or use rTMS in their current practice. rTMShas the highest level of evidence for the treatment of unipolar depression, provided that effective parameters are used, that is to say, for classical high frequency protocols: 20 to 30 sessions, 1000 pulses/session, 5 to 20Hz, and 110 % of the motor threshold. Low frequency protocol are also efficient and well tolerated. The duration of the efficacy varies with relapses rates around 50 % at one year. Pharmacological treatment generally remains associated. With regard to manic states, and mixed states the results are preliminary and limited to a possible reduction in symptoms. In the suicidal risk associated with mood disorders, the interest of rTMS is still to demonstrate, as well as in catatonia. The current place of the rTMS is no longer disputed in the curative treatment of major depressive disorder, preferentially used after one or two lines of antidepressants upstream. Further studies are needed to confirm preliminary positive findings in other aspects of mood disorders.
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